santa molina, licsw director of counseling & advocacy dc ... · fight/flight survival mode...
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Santa Molina, LICSWDirector of Counseling & Advocacy
DC Rape Crisis CenterWashington, DC
202-232-0789 x 1202Smolina @ dcrcc.org
Expectations and Outcome Common Truths and Givens
What Constitutes a Trauma
Trauma affects Body, Brain and Nervous System
Uniqueness of Trauma Work
Basics of Somatic Experiencing Model
Self Care - Caution to Service Providers
Some Basic TruthsAbout Human Beings: We have the innate ability to heal ourselves by self
regulating and consistently re-establishing a sense of homeostasis
We experience life on Physical, Emotional, Mental, Spiritual, Behavioral levels
We are affected by all aspects of our environment; social, political, racial, class, culture, sexual and gender identity and ability
Some Basic TruthsAbout the Body:
It has incredible wisdom and holds all of our memories, it is a historian and a teacher
It serves as a container for our sensations and feelings
It separates us from the environment and others
It belongs to us
It is the “temple of the soul”
It defends us against unbearable affect
It is an Armor and always speaks the TRUTH
What Constitutes a Trauma? An incident perceived to be life-threatening, that
startles, stuns and /or overwhelms us, leaving us altered or disconnected from our bodies
A incident that ruptures the body’s stimulus barrier, an individual’s range of tolerance
It is defined not by the incident or the event, but by how the individual responds to the incident or event
Common Responses to Trauma Hyper-arousal (activation)
Constriction (tightness/tension)
Dissociation (leaving/fleeing)
Feelings of numbness (or freeze) resulting in a sense of helplessness and hopelessness
Time Limitations The common responses to trauma re involuntary,
psycho-physiological reactions to overwhelm, they are intended to be time limited
When the nervous system is not restored to balance, “secondary symptoms” can develop weeks, months, or years later
75% of clients have traumatic symptoms that remain dormant for years
Onset usually 6-18 months
Neo-Cortex “New” part of brain
Frontal Lobe
Responsible for inhibition of actions
Complex, rational thinking; planning; perception
Speaks the language of Words
Limbic System The “midbrain,” the mammalian brain
Amygdala, Hippocampus, Thalamus
Responsible for emotions
Processes memory and emotion
Speaks the language of feelings
Reptilian Brain “The Primitive Brain”
Brain Stem and Cerebellum
Most instinctual part of brain
Controls basic survival Fight, flight, freeze
Speaks the language of sensation
Neurobiology of TraumaCentral Nervous System
Sympathetic (SNS)
Fight/Flight Increased heart beat, blood
pressure
Muscular Tension
Fast and shallow respiration
Blood flow moves away from digestive and skins organs and into large motor muscles of flight
Pupils dilate
Muscle fibers become excited
Verbal ability decreases
Parasympathetic (PNS)
Relaxation Response Slower heartbeat, blood pressure
and muscular tension
Slow and deep respiration
If Fight/Flight is not successful than the PNS goes into
FREEZE
Immobility
Shock
Shutdown
Post Traumatic Stress Disorder:a Threatening Event takes place
Amygdala (limbic brain) Senses thereat and fear
Reptilian Brain (brain stem ) activates the fight/flight survival mode
Emotion from the original event leaves an imprint
Bypasses the Neo-Cortex (rational brain)
With PTSD – the Fight and Flight response is not completed, consequently the Ne0-Cortex is held
hostage by the limbic brain, unable to access a sense of safety, rendering this process incomplete.
Trauma Symptoms
Fight/Flight
Anxiety, abrupt moods
Sleeplessness
Nightmares, flashbacks
Digestive problems
Hyper-vigilance
Muscle ache and pains
Sensitivity to light/sound
Freeze Dissociation Depression, isolation Hopelessness Numbness, lethargy Forgetfulness Fatigue, aches, pain Head, stomach aches
The Process of Healing from Trauma
Focus on moving the survivor towards completing the traumatic process
Trauma symptoms are the result of a highly activated, incomplete biological response to threat, frozen in time
By enabling the response to thaw and complete itself, trauma can be healed
To Thaw, it is necessary to work with built-up energy activated in the body and help it to gently discharge –allowing the experience to complete
The Goal of Trauma Work Re-stabilize a highly activated or shut down
nervous system by balancing trauma symptoms and resources
Discover, and re-cover missing, strong, instinctual parts of being
Reclaim our bodies, minds, spirits, and emotions
Relate to ourselves and those around us with more vitality
Help prevent future trauma symptoms
Experiencing Healing Balance sensations with resources
Locate and deepen place of well-being in the body or outside of it
Sense into activation, constriction/traumatic material in the body
Move back and forth from sensing activation to sensing well being
Build more resiliency
It is not enough to image or think it, the well being must be felt, tracked in the body, recognized , reorganized and assimilated
Caution:A new way of Telling the Story Nervous system cannot tell the difference between the
original event and the telling of the event
Be mindful when client re-tells story, pace it between activation and resource
Notice client’s nervous system response
Strategy of the Work: To create awareness of increased capacity to tolerate trauma
Grounding, Centering and Containing
Resourcing: internal and external
Tracking: Sensations and emotions
Pendulating: moving from activation to resourcing
Discharging Activation: letting go of build up energy
Orienting and Integrating: returning to a place of homeostasis – Time is of essence here
Self Care: Preventing Compassion Fatigue
Key Awareness
Our body, brain and nervous system responds the way our client’s do
Secondary Post Traumatic Stress is measurable
Somatic Transference and Counter- Transference exist
(client’s somatic responses will evoke ours and vice versa)
Key Questions:
Do we have our “own” traumatic experiences to track? (what internal dialogue may we be having?)
How is the survivor’s trauma affecting us?
What are we sensing and feeling, and can our somatic experience be of service to the survivor?
Are we staying regulated?
Thanks to:
Beth Wheeler, LICSW in Somatic Experiencing Practitionerin Private Practice in DC
For her knowledge, generosity and body wisdom
The Somatic Experiencing Trauma Institute(formerly known as The Foundation for Human Enrichment)
Peter Levin for his incredible insight and respect for All Beings